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HomeMy WebLinkAboutNICHOLS CONSULTING ENGINEERS (NCE) (2) - 20170City of Santa Ana Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached dgte9 eVarf a?:150 amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention t' I �pts; have been satisfied prior to signing the termination form- o y'-% Uf COUNOiL Is the agreement(s) a permanent record? Yes No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with A No. A-a--o/7-- a�Lfd was completed on (List all amendments. Use space below If needed.) COTC Office Use Only �� �� ✓ and final payment has been made. Department: ��y � Aj Phone/Ext.: Signature: f U< (9-8kta— Date: Revised: 10-1 B-16 INSI RANCE NOT ON FILE A-2017-290 WORK MAY ME PROCEED CLERK OFCOLIN% DAT'QRVR& NT TO PROVIDE PAVEMENT MANAGEMENT PROGRAM UPDATE ONCEIS AGREEMENT (Nichols Consulting En in ersand norr"Consultand into t 17th day of and the City of Santa Ana, 17 by a charter city � g g )= Y � Y and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. On August 15, 2017, the City issued Request for Proposal No. 17-092, by which it sought consultants to perform pavement condition surveys and budgetary analysis as part of the update to the City's Pavement Management Program and in accordance with the guidelines by the Orange County Transportation Authority. B. Consultant submitted a responsive proposal that was selected by the City. Consultant represents that it is able and willing to provide the services as described in the scope of work that was included in RPP No. 17-092 and attached as Exhibit A to this Agreement. C. In undertaking the performance of this Agreement, Consultant represents that it is lmowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform the services that aw described in Exhibit A. Consultant's proposal is incorporated by reference as though fully setorth herein. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services under this Agreement, the rates and charges identified in Exhibit B. The total slam to be expended under the term of this Agreement, including any extension periods, shall not exceed $94,105. This amount is comprised of (1) the base sum of $85,550 and (2) a 10% contingency of $8,555 for services to be performed at the sole discretion of the City. b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. Page 1 of 8 3. TERM This Agreement shall commence on the date first written above and terminate on October 16, 2019, unless otherwise terminated earlier in accordance with Section 16. The term of this Agreement may be extended for one additional 1-year period upon a writing executed by the City Manager and the City Attorney. 4. PREVAILING WAGES Consultant is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq,, ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. If the services being performed are part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and the total compensation is $1,000 or more, Consultant agrees to frilly comply with such Prevailing Wage Laws. Consultant shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 5. INDEPENDENT CONSULTANT Consultant shall, during the entire term of this Agreement, be construed to be an independent consultant and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Docrunents & Data"). Consultant shall require all subconsultants to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subconsultant prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City, City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. Page 2 of 8 INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subconsultants, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles, The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles, c. Worker's Compensation Insurance, In accordance with the provisions of Section 3700 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self- insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Consultant is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. C. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: i. Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement, ii. Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. iii. Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. iv. Consultant shall supply City with a fully executed additional insured endorsement. F. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has Page 3 of 8 been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City, 8. INTDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant, its subconsultants, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 9. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. 10. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with. respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) ,years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three Page 4 of 8 (3) years from the date of final payment to Consultant under this Agreement. 11. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means, Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 12. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services. Conflict may be further specified in Certifications - Exhibit C, attached hereto and incorporated in this Agreement by reference. 13. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations and as further specified in Certifications - Exhibit C, attached hereto and incorporated in this Agreement by reference. 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terns of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the.City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instruniont that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which is not embodied herein. Page 5 of 8 15. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other Consultants retained by City. 16. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 17. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 18. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California, Both parties farther agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 19, PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other govermnental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and Page 6 of 8 exemptions. Said inability shall be cause for termination of this Agreement. 20. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. 21. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With courtesy copies to: Fred Mousavipour Executive Director, Public Works Agency City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, California 92702 Fax:714- 647-5635 To Consultant: NCE 9550 Warner Ave, Suite 370 Fountain Valley, CA 92708 Attn: Lisa K. Senn, Senior Project Manager Fax: 714-848-8897 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, Page 7 of 8 communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Maria D. Huizar Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: t,, John c Assistant City Attorney FOR APPROVAL: FRED MOUSAVIPOUR Executive Director Public Works Agency CITY OF SANTA ANA Raul Godinez II City Manager CONSULTANT: Nam n� Palmer Title: Principal Page 8 of 8 Appendix ATTACHMENT 1. SCOPE OF WORT{ CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR PAVEMENT MANAGEMENT PROGRAM UPDATE RFP NO.: 17-092 Introduction and Background: The City of Santa Ana is seeking a qualified consultant to perform pavement condition surveys and budgetary analysis as part of the update to the City's Pavement Management Program (PMP). The PMP surveys and analysis shall comply with Orange County Transportation Authority (OCTA) guidelines. The City's roadways consist of approximately 450 centerline miles of paved streets and alleys. The roadways are divided into three networks: Master Plan of Arterial .Highways (MPAH), Local Street, and Alley. The MPAH Network contains approximately 105 centerline miles of Major Arterial, Primary Arterial, Secondary Arterial, and Collector streets with AC and PCC surfaces. The Local Street Network contains approximately 317 centerline miles of residential and non- residential/industrial streets with AC and PCC surfaces. The Alley Network contains approximately 28 centerline miles of alleys with AC and PCC surfaces. The pavement conditions of the arterial and local networks were last surveyed in 2016. These data were input into PAVER 7.0 and the budget analysis utilized this software. The City migrated the PMP to StreetSaver software in 2017; therefore, all works for this scope of services shall utilize the latest version of StreetSaver software. Description of Work: The proposal should include the following tasks and fees and any additional tasks and fees deemed necessary by the Consultant shall be clearly identified in the proposal. Additionally, the City reserves the right to provide Notice To Proceed (NTP) for any, all or none of the following optional tasks: MPAH Network Task 1.1- Management and Administration The Consultant shall monitor project progress and maintain project files. Other responsibilities include supervising and reviewing the inspection process for conformance with OCTA guidelines, The Consultant shall meet with City staff to review schedule, budget, project documents, project goals, format of deliverables and clarify responsibility of each party. Task 1.2 - Pavement Condition Surveys Collect and record pavement distress data, as per ASTM D6433-11 and OCTA guidelines. The pavement distress data shall be collected using the walking survey method; windshield surveys will not be accepted in lieu of walking surveys. City of Santa Ana RFP 17-092 Page /Al-1 Input pavement distress data into the City's database and calculate Pavement Condition Index (PCI) for each segment utilizing the latest version of StreetSaver software. The consultant shall keep a log of any discrepancies between the database information (i.e. surface type, etc.) and actual field conditions, and shall coordinate with City staff to correct the database as necessary. Corrections/changes to the database shall not be made without prior City staff approval. Task 1.3 - Budgetary Analysis Forecast future PCI values for each segment and create OCTA-required budget scenarios for each network utilizing the latest version of StreetSaver software. The consultant shall coordinate with City staff to develop a 7-year maintenance & rehabilitation strategy (including but not limited to selecting segments, treatment type, costs, and year of implementation). Task 1.4 - Final Report (Optional Task) The consultant shall prepare a final Pavement Management Program report and any other required submittal items, as per OCTA guidelines. The report shall include, without limitation, the methods, findings and recommendations of the consultant, which shall be presented in a single comprehensive document which, should include findings generated as part of other tasks described herein. Local Street Network Task 2.1- Management and Administration See Task LI above. Task 2.2 - Pavement Condition Surveys See Task 1.2 above. Task 2.3 — Budgetary Analysis See Task 1.3 above. Alley Network (Optional Task) Task 3.1- Management and Administration See Task 1.1 above. Task 3.2 - .Pavement Condition Surveys See Task 1.2 above. Cfty of Santa Ana RFP 17-p92 Page Al-2 General Requirements All work shall be performed in conformance with the City and. OCTA's policies, procedures, and standards. The Consultant has total responsibility for the accuracy and completeness of all inspections performed and documents prepared. The documents furnished under the Agreement shall be of a quality acceptable to the City. The criteria .for acceptance shall be a product of neat appearance, well organized, and technically and grammatically correct. The assumption of the number of review rounds is not allowed. • The City has traditionally used paper distress forms but electronic data collection (using laptop/tablet computers) will be acceptable. The paper distress forms shall be submitted to the City for the City's records or the methodology for upload of electronic data collected shall be clearly defined and a method for data verification provided. Proiect Deliverables + Updated database in StreetSaver. • Final PMP report; digital file on, CD and 1 bard copy. Project Schedule and, Milestones • Notice To Proceed Week of October 30, 2018 • Complete inspection and submit data of MPAH for review Week of March 5, 2018 • Complete Budgetary Analysis Week of March 26, 2018 • Submit Draft .Pavement Management Report Week. of April 16, 2018 • Complete Final Pavement Report May 22, 2018 City of Santa Ana RFP 17.092 Page Al-3 EXHIBIT B COMPENSATION Fee Proposal City of Santa Ana Pavement Management System Update 2017/2018 Cost Proposal Assumption$: Task 1,2 assumes walking surveys for approx. 105 centerline miles (994 MPAH sections). Task2.2 assumes walking surveys for approx. 917 centerline miles (1,996 local sections). Task 3.2 assumes walking surveys for approx 28 centerline miles'(280 alley sections). All field surveys include 5%QC. Task .IA Includes OCTA required reports and appendices. Prepared by. Nichols Consul8ng Engineers, Chtd. September2017 EXHIBIT C CERTTBICA.TIONS C-1 through C-3 Appendix ATTACHMENT 3-1: NON -COLLUSION AFFIDAVIT CE, RTIFICATIONS NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public.Conuvct Code Section 7106) To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS Inaccordance with Title 23 United States Code Section 112 and Public Contract Code7106 the: BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid; and has not directly or indirectly colluded, conspired, connived or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall. refrain from bidding; that the BIDDER has not in any tnamner, directly or indirectly, sought by agreement, corimunicatlan, or conference with anyone to fix the bid price of the BIDDER or any BIDDER, or to flx any overhead, profit, or cost element of the bid price, or of that of any other BIDDER,. or to secure any advantage against the public body awarxiing the contract of anyone interested in the proposed contract; that all statements containedin the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents: thereof, or divulged information or data relative thereto, or paid, and will notpay, any foe to any corporation, partnership, company association, organization, bid depository,or to ally member or agent. thereof to effoctuato a collusive or sham bid. The above Non -collusion Affidavit is part of file Proposal. Signing this Proposal on the signature thereof shall also constitutesignature of this Non -collusion Affidavit. BIDDERS are cautioned that. a falsylKation may subject the certifier to criminal prosecution. Signed State of California County of Subscribed and sworn to (or affluued) bcroro the on this. _ day of , 20_, by before me, r proved to me on the basis of satisfactory cvidence to be the persou(s) who appeared (sue. Affacred) Notary. Public Signature :Notary Public Seal City of Santa Ana RFP Page A3.1 (tl ( Fn 23 L05 30) Paw me,,nt I: , rvl;errco !'ret;ranr Uor9 #z,.RFP N,..: 17-032 I City ofSitrr l Arai Certifications CALIFORNIA JURAT WITH AFRIANT STATEMENT GOVERNMENT CODE § 8202 0 See Attached Document (Notary to cross out lines 1-6 below) ❑ See Statement Below (Lines 1-6 to be completed only by document signer[s), not Notary) z Signature of Document Signer No. '1 Signature of Document Signer No. 2 Of any) A notary public or other officer completing this certificate verifies only the Identity of the individual who signed he document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document, State of California County of Cohfm (o jn olN6 SHU LIAO Commission N 2129629 Notary Public, California Contra Costa County M Comm. E Ires Oct 9, 2019 Subscribed and swern—to-{ee affirmed) before me on this 24 day of Auqus-1' 20 17 , by Date Month Year Name(4 of Signer proved to me on the basis of satisfactory' evidence to be the peraono who appeared before me. Signature _ S nature Ntary Public Seat Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: N)n-collasfori ArrHoW+C lF+ca}ro s Document Date: No da)a Number of Pages: pne Signer(s) Other Than Named Above: No &fkW ianus 02014 National Notary Association - www.NationalNotary.org • 1-800-US NOTARY (1.800-876-6827) Item #5910 (WE#231MU 30)PavemsntMal ag<amen: Pro oramUrdatr.,R,PNO,:17.092iCity ofSantaAnal Appendix ATTACHMENT 3-2: NON -LOBBYING CERTIFICATION CERTIFICATIONS The prospective participant certifies, by signing and submitting this bid or proposal, to the best 'of Inns or her knowledge and belief, that; I. No federal appropriated funds have been paid or will be paid, by on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress In connection with the awarding of any federal contract, the making of any federal grant, die making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. 2. If any funds other than' federal appropriated funds have been paid orwill 'be paid to any person for Influencing or attempting to influence any officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant loan, loan or cooperative agreement, the undersigned shall complete and submit a "Disclosure of Lobbying Activities". This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,'Title :31, U. S. Code. Any person who fails to file the required certification shall be subject to acivil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. NCE Signed and Printed Name: /L Title Vice President/Principal 9/7/17 City of Santa Ana RFP Page A3-2 Margot Tapp, PE ( iNCt : 23.LU6,30) Pavement IV4jn;) ;en}ent Prn�Inram Update) RFP No.: 17-092. 1 City of Santa ltna Appendix ATTACHMENT 3-3: NON-DISCRIMINATION CERTIFICATION CERTIFICATIONS The undersigned consultant or corporate officer, during the performance of this contract, certifies as follows: The Consultant shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The Consultant shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race,'color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or otherforms of compensation; and selection for training; including apprenticeship. The "Consultant agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The Consultant shall, in all solicitations or advertisements ror employees placed by or on behalf of the Consultant, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin, 3,. The Consultant shall send to each labor union or representative of workers with which he/she has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Consultant's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Consultant shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The Consultant shall furnish all information and reports required by Executive Order 1.1246 of September 24, 1965, and by rifles, regulations; and orders of the Secretary of Labor, or pursuant thereto, and will permit access to Iris/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Consultant's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Consultant may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions .may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. 7. The Consultant shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted City of Santa Ana RFP Page A3-3 (NWE4 2:31,05.30) Pavement prl,I IMI`enWent PragrUm U}tdate, UP rla.: 7 7.092 1 City o[Santa Ana r by rules,; regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enrorcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Consultant becomes involved in, or is threatened with, litigation with a sub -consultant or vendor as a result of such direction by the administering agency, the Consultant may request that the United States enter into such litigation to protect the interests of the United States. 8..Pursuant to California Labor Code Section 1735, as added by Chapter 643 Slats. 1939, and as amended, No discrimination shall be made in the employment of persons upon public works because of race; religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided in Section 1420; and any consultant of public works violating this Section is subject to all the penalties imposed for a violation of the Chapter. Signed:'�_1_ Title: Margot Yapp,PE' Firm: NCE Date: 917/17 Page (NU it 2.3'1.0'.30) Pavement Maoagamant Pea'.rain UPtlate, RFP Nu.: 17-n92 1 City V4 Santa Ana NICHCON-02 AUSTINA '4� R� CERTIFICATE OF LIABILITY INSURANCE DAT/16/2D/YYYY) 2/16/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # OE67768 IDA Insurance Services 4370 La Jolla Village Drive Suite 600 CONTACT Erica Wilson NAME: PHONE FAX A/c, No, Et); (858) 754-0063 50233 A/c, No):(619) 574-6288 E-MAIL rca.son Ioausa.com ADDRESS: Erica.Wilson@ioausa.com San Diego, CA 92122 AFFORDING COVERAGE NAIC # INSURER A:RLI Insurance Company 13056 INSURED INSURER B: Crum 8r Forster Specialty Insurance Company 44520 INSURERC: Nichols Consulting Engineers, CHTD INSURERD: 1885 S. Arlington Ave., #111 Reno, NV 89509 INSURER E : INSURER F : _ CCIVFRAnFS CFRTIFICeTF NIIMRFR• RFVI41n1J nt11MRFo- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTRTYPE OF INSURANCE A DL! UBR POLICY NUMBER MMLDICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH $ 1,000,000 _OCCURRENCE-. SAGE TO RENTED $ 1,000,000 CLAIMS -MADE X OCCUR X PSB0003222 05/17/2017 05/17/2018 X Cont Liab/Sev of Int MLD EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY S 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY jE� LOC GENERAL AGGREGATE $ 2,000.000 GEN'L PRODUCTS - COMP/OP AGG $ 2,000,000 Deductible I S 0 OTHER: A AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X IPSA0001184 05/17/2017 05/17/2018 COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY Perperson)$ $ 1,00 ,OOO BODILY INJURY Per accident $ Parr a cident AGE $ X y� ED AUTOS ONLY AUTOS ONNIY Comp.: $ 500 X Coll,: $ 500 , A UMBRELLA LIAB X OCCUR j ! EACH OCCURRENCE $ 5,000,000 AGGREGATE X EXCESS LIAB CLAIMS -MADE PSE0003030 05/17/2017 05/17/2018 $ 5,000,000 DED RETENTION$ A WORKERS AND EMPLOYECOMPENSATION S N A TILOITI' ANYPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? LN (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below ! NIA X 'PSW0001955 05/17/2017 05/1712018 X STATUT ER OTM- 1000,000 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE- POLICY LIMIT 11000,000 B Prof Liab/Clms Made PKC105019 05/17/2017 05/17/2018 Per Claim 2,000,000 B Ded.: $10k Per Claim PKC105019 05/17/2017 05/17/2018 I Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS i VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Agreement Nos. A-2017-172 and A-2017-290 City of Santa Ana, its officers, employees, agents and representatives are Additional Insured with respect to General and Auto Liability per the attached endorsements as required by written contract. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies to Workers' Compensation. 30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisi S. REVIEWED BY: EUNICE HEREDIA (PG i OF ) City of Santa Ana 20 Civic Center Plaza, M-36 M-36 PO Box 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Named Insured: Nichols Consulting Engineers, CHTD Policy Number: PSB0003222 RLI insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack° FOR DESIGN PROFESSIONALS BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM - SECTION II — LIABILITY 3. C. WHO IS AN INSURED is amended to include as an additional insured any person or organization that you agree in a contract or agreement requiring insurance to include as an additional insured on this policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "product -completed operations hazard". 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this policy. b. This insurance does not apply to the rendering of or failure to render any "professional services". c. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of insurance. 3. The following is added to SECTION III H.2. Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION II — LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an PPB 304 06 10 additional insured under this policy must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b. The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement. 4. The following is added to SECTION III K. 2. Transfer of Rights of Recovery Against Others to Us — COMMON POLICY CONDITIONS (BUT APPLICABLE TO ONLY TO SECTION 11 — LIABILITY) We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal and advertising injury" arising out of 'your work" performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Page 1 of 1 REVIEWED BY: EUNICE HEREDIA (PG Named Insured: Nichols Consulting Engineers, CHTD This enaorsement.. moclities insurance provided uncier the tollowlnq.`, BUSINESS AUTO *COVERAGE. FORM A. $road Fdrm Named Intuted The following is added to.. the SECTION: 11 — LIABILITY Coverage,' Paragraph. A.1, Who Is An Insured Provision:. Any business- entity newly. acquired or formed by you during the policy period, provided. YOU. own fifty percerif. fp011/o) or more Of the business entity and the business entity. is not separately insured: for Business, AtAo Cioverage: Coverage is extended up to zi� maximum :or one hundred eighty .(1-80) days -following. the acquisition- or formation of:the business .entity. This provision. does not apply to any person or organization for -which coverage is excluded by., .endorsement. B. Employees As Insureds The following is: added to the SECTION 1.1 — LIA611LITY 0 .PVEKRqK, Hajr.8groph A.I. Who.ls An Insured Provisi . on: .Any "employee" of yours is an "insured" while using P, covered. "auto" :you don own: hire :or borrow in yoqr.bu.siness QT your personal affairg.: C.. OlanketAdd!Oonal Insured The foll.owirig is. added to the. SECTION. 11 LIABILITY- COVERAGE Paragraph A.I. Who; ls:An Insured Provision: .Any person or .organization .that you are required to iholude as -tin additional insured On :this coverage form in a oo:ritraot Or agreement that is executed by you, before.. the "bodily infury'; or "pro . perty damage" occurs 'is: an "insured" for Ilabil-p- boverago,:taut only for 'damages t , o which this insurance op,plfes- and 011ty to e&liefft that ploftior! 01 ur,yAnfzaLiurj qualifies. as an '!insured" under the " M-o Is An Insured. provisioncontai ne0 in SbbTFON 11 — LIABILITY COVERAGE The. insurance provided1tollie. additional insured will he o.n:o primary arid non!-contrlbutop.v basis to the :additional in-.Lffed'S ovin business 2L40 coverage if you are. required to do so in a contraq.t -oragref nerlt 'that is e.k.ebut6d by you before the "bodily injury" or. "property damage" occurs. D. Blanket Waiver- O`f Subirboation The following is .added to the SECTION IV — BUSINESS: AUTO CONDITIONS, -A. Lbso Conditions, 56 Trahsftt Of Riglbts::Qf .ecoR 6 very .Against Others To U$: PPIA SOO Oa 11 Policy Number: PSA0001 184 We Waive any right of teooiyery We may have against :any ­person.or.organization to the extent required of yom by -a odr*act executed prior W any "adoident" or provided 'that the "accident" of arises .but. of;the operations contemplated by..such contract. The waiver applies only to the* person or dr9anizatiom-designat6d in Such contract. S ErnpJoyee-Hired.Autos 1. The following is• added to the -SECTION 11 . LIABILITY: COVERAG E, - Pareigialih. -A.1. Who Is An Insured Provision: M -empiuyee- ttr yours. it; -art "iiisuiwa­ while; operating an, "auto'' *hired ,or rented under a contract or agreement in that "employee's" name, with your permission, while peffo.rmin .9 duties related totheconduct ,of your -business. 2. Changes In n General Conditions: Hpragra,plj S.b. of Ia. Vther Insorance Condition . i . n the BUSINESS AUTO CONDITIONS is deleted and replaced with the following-, bt For Hired Auto Physical Damage. Coverage, the - following are -deemed :to be: oovered. "autoon ypu:own: (1:) Any covered !auto" you.jease, hire,: rent orborrow; and (2)r. Any covered "auto" hired or rented. by your "employee" under a cointract in that individual "employee's" came, with your perrni t5%Sjqn, while; pt-(.fPMiiriq dUties related to, the conduct of your .business. However, any, ''auto" that leased, hired, r0hted or b.orroWedwith a driver' is -not. a.covered "aulb. 0:7. Fe.1low. Eniployee, Coverao.q. S>rCT10N ii — LIABILITY COVERAGE, Exclusion B.S. does. not apply if . you have workers compensation insurance- in -force coyeri. g al I of. your Auto, Loan Lease -Gap Coverage. SECTION III — PHY.S.10-AL DAMAGE. COVERAGE, C. Lirdit Of Insuronc.6,. is amended by th6 addition 6f'the f6116Wing: In the, event of .6. total "loss" to. 6­60ver'd e - auto" ishowh in the. Schedule of Declarations, we will paV any; unpaid amount due on the. lease or toph for a .covered 'VUW.", less: =JA REVIEWED BY: EUNICE HEREDIA (PG; OF(/) Named Insured: Nichols Consulting Engineers, CHTD Policy Number: Pswool71955 WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 d. 04-84j WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA We have the right to recover our payments from anyone liable for an Injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be _ % of the California workers' compensation premium otherwise due on such remuneration. Person or organization Schedule Job Description All persons or organizations that are party to a contract that Jobs performed for an person or organization requires you to obtain this agreement, provided you that you have agreed with In a written contract executed the contract before the loss to provide this agreement REVIEWED BY: EUNICE HEREDIA (PG gOF, , ) IkiIus] 1097e7.Q1y7 ALISTINA . 1`%� R CERTIFICATE OF LIABILITY INSURANCE `018 DATE 5/10/210/2 D,YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # OE67768 IOA Insurance Services 4370 La Jolla Village Drive Suite 600 CONAMTA NE: CT Erica Wilson PHONE (A/C, No, Ext): (858) 754-0063 50233 jac, No):(619) 574-6288 EMAIL rca.son loausa.com ADDRESS: Erica.Wilson@ioausa.com San Diego, CA 92122 AFFORDING COVERAGE NAIC # INSURER A:RLI Insurance Company 13056 INSURED INSURER B: Crum 8r Forster Specialty Insurance Company 44520 Nichols Consulting Engineers, CHTD INSURERC: 1885 S. Arlington Ave., #111 INSURERD: Reno, NV 89509 INSURER E : INSURER F : COVFRAGFS CFRTIFICATF NLIMRFR- RFVIRIAN NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR ^POLICY EFF POLICY EXP LIMITS LTIR TYPE OF INSURANCE POLICY NUMBER A X COMMERCIAL GENERAL LIABILITY ,EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE [j OCCUR u X pS60003222 05/17/2018 _ AMAGE TO RENTED 1,000,000 05/17/2019 �EIES--IEa_aecuaa $ Cont Liab/Sev of Int I --------- 10,000 X MED EXP (Any one rson) $ LPERSONAL 8 ADV INJURY _ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: !GENERAL AGGREGATE $ 2,000,000 ❑X JECT -_ 2 OOO,OOO POLICY _ LOC PRODUCTS-COMP/OPAGG $ OTHER: ,Deductible 0 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 1Ea_accident) I $ X ANY AUTO X PSA0001184 05/17/2018 05/17/2019 j BODILY INJURY Per person i $ _ SCHEDULED AUTOS ONLY AUTOS BOORDILY INJUppRY (Per acc(dent $__-_- Ep AUTOS ONLY AUTOS ONNLY - (PeOacEclRden rMAGE - -- - -- - __-- X Comp.: $500 X 'iColl.: $500$--_- , A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS -MADE PSE0003030 ',! 05/17/2018 05/17/2019 AGGREGATE 5,000,000 DED RETENTION $ j A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ! X PER PTtTI,IT�-_- _ERH -, _ - ANYPROPRIETOR/PARTNER/EXECUTIVE Y/-N X PSWOOO1955 05117/2018 05/17/2019 1,000,000 E.L..EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) - N / A _ _- _ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below - _- - E.L. DISEASE - POLICY LIMIT 1,000,000 B Prof Liab/Clms Made PKC107494 05/17/2018 05/17/2019 Per Claim 2,000,000 B Ded.: $10k Per Claim I PKC107494 05/17/2018 05/17/2019 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Agreement Nos. N-2017-142 and A-2017-290 City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds with respect to General and Auto Liability per the attached endorsements as required by written contract. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies to Workers' Compensation. 30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy r isions. REVIEWED BY: EUNICE HEREDIA (PG OF L ) City of Santa Ana 20 Civic Center Plaza, M-36 M-36 PO Box 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Narned Insured: Nichols Consulting Engineers, CHTD RLI Insurance Company Policy Number: PSB0003222 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPacko FOR DESIGN PROFESSIONALS BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINE SSOWNERS COVERAGE FORM - SECTION II — LIABILITY C. WHO IS AN INSURED is amended to include as an additional inured any person or organization that you agree in a contract or agreement requiring Insurance to include as an additional insured on this policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf: a. in the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and Included within the "product -completed operations hazard", 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. This Insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically Is added by another endorsement to this policy. b. This insurance does not apply to the rendering of or failure to render any "professional services". c. This endorsement does not increase any of the limits of Insurance stated In D. Liability And Medical Expenses Limits of Insurance. 3. The following Is added to SECTION III H.2, Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION II — LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an additional insured under this policy must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b. The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered Into that contract or agreement. 4. The following is added to SECTION III K. 2. Transfer of Rights of Recovery Against Others to Us •- COMMON POLICY CONDITIONS (BUT APPLICABLE TO ONLY TO SECTION 11 w LIABILITY) We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal and advertising injury" arising out of 'your work" performed by you, or on your behalf, tinder a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered Into by you before the "bodily Injury" or "property damage" occurs, or the "personal and advertising Injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. PPB 304 06 10 Page 1 of 1 REVIEWED f; ! EUNICE HEREDlA Named 1111SLired: Nichols Consulting Engineers, C1111D '111-ls e'naor$ement modMos Insurance provided Urlder' the BUS1NES,S AUTO *MVERM33E. FORM A. 100ad Fd'rm N;kmdd Iftuted 'The 'following is added to.. the SISCTION. If — LIABILITY C"Overage,: Paragraph, A.I. Who Is An Insured Provision:. .Any, business- entity newly.acquired or formed by you during the policy period,. provided'VOLI. own fifty percerif f)0%.) or. more of the business entify, and the business entity, is not -separately insured: for Duslne5s, ALftO Coverage 0overage 1 15 extended up to a� maximum :of one hundred el.ghty (1.8Q). days following. the acquisition -or forimfibn ofthe business .entity. . Thi.s. provision, doesnot. apply- to any person. or. Oroani�;ation for -which coverage is. ekluded by., end'orsernent, 13. EMO.loyoes As Insureds The, following is: added to the SECTION III — LIA410TY H.a 00VERA.Pr - ' . ;, .MgrqprI A.A. Who -.ISM Insured Provision: ,Any "employee" oyee".0f-ymirs is an "insured"while -using 'P "!aLl1;o":you dpn't own. , covered hire- :or barrow. In you. r. bu.m M0,5s.'O.T your pofson d.. 9.!;ank0t-A4dftI0hW llrtparo.d 1he. folloWlrig is. added to the SEPT-ION. 11 LiA*IBILIT-Y—.C.OVER,A-'GE;,Fai'a rppO.- A.1. Who :.I s..:An Insured 'Prov . Isio . !1: .Any,, .person or organization .that you are reqqirot,1 to ih.ol . ude.,,a.,$. M additional "insured on .this -overage form in a oontraot. Or. aonJeMenit that is Ox=uted by ypq: before; the "i od ily injury' or "propertyy damagd" ow,Q*r8 Is: on 'lihoured.""f6'r ii4tbit$y 0verAi but only for :damages to whloh this. Insurarioe, opplips, ond' q0P(IM01.8. 4s 0*1)� "IrMU'red" under the 'Who 19 An In8ured provision- -r.ontained: in Sed'TION is LIA,au,iTY• covaKAGrm: tie. insurance provided to, the, add.ltional.Invi ured will beon:,a primary and non: -contributory 4 asfs.ta the .apldlitidn;l'j in'SLII*9d!S .0wh buslriq%s auto ;Coverage, if "that is eXebut6d bV.Ydu before the "bed ly injury" at "property damage" ooqurs. . t-$qbr,b9atiqq The follo%A!ing Is added to the SECTION IV — OWSIN1580 AUTO OONDITIONS, A. Lksi; Conditi6nsi, 56 TraM;N't Of, Rilghts,,Of RocdVft Aggifist Others- TP, Us: P i P.A100 Policy Number: PSA0001 184 'M Waive, any r[ght.0 recdyerV �jve tay'have against :wy'person,or 6rqa nization to t . -he ekteht required -of YOU lb.y aodr*aat bxeQuted. ph.6r to &ny, "aboldont"or :`toss", provided 'that the ''a-ccide.nt" 6� orlsoe 6utof'the-operaf,ions contemplated by.suoh contiki. Thb.waiver applies ohly. .,to the' pergon or drg,zinization:,.de,signat6d'ir.'sLich. contract. 'E. EmPlloyee-Hired,Autos: I.- The fallowing is. addd to the .000TION If LIABILITY: COVERAGE, Pora.g.ta,lih. AA. Who Is An Inauxed provision: An "umpluyyours. 1, a& ar ins .an "illsullud" W1111u. operating an, "auto" -hired or rented under a contractor agreement in. that. "empl , oyee',S)l name, with YOLIF perm.isstoii; while, pefforming duties related to -the' conduct of your business. 2 - , Change's in, n, General Conditions; 1aragrapn $.b, of'the: 'lunar 1"uranc.'o Condition in the WSINM AUTO 'CONDITIONS is deleted and replaced with the following:, b. For 141red Auto Phyoloal Damage, Covo"r g the following are -deerned :to be: covered ,!autoe" YQU:Own: -(4 Any covered "auto 'y0.uJease hire,: rent orborrow; ar(d Any, covered Or rerited., by your "emplope" under a namecontrwA10that 'individual .With. r '!e - mploye#$" '', yoq !t1b.rI1t!ei'd,tq the corlduct of your business, 'HQwever, any,, "auto" 'that J, qc), hired, ranted or borroWodWith 0 driver Is -not. 8.QoVorv6:"au.f0.P 011 SkIlow omploypo cover4gg 4EG-TION 11. — . LIASIL14Y COVEMA'P'E, Excluslop doos, pCit opply..", If' you ave wo e N hers compensation lheurance.1n4orce covering all of -your 0, -Auto. Loan Lenso7 Gap -0,oyo SECTION Ill.. — PHY,51-C-All. DAMAGE 00VERAGE, :1P. Lfrr*.Qf'InsdMhq6, Is amended by. thd addltion .6f'the f6ll6W[ng: In the: went 'of a. tofal '"loos"' t,6. 4*60vOtOd :showh'ih of Qo.'00'ratlons, %1~i will 'pay stray unpaid arnount due 'on the; lease or loan f.pr a -045vet6d "auto", lesis: EUNICE HERE 21A(PQ QFq) Named Insured: Nichols Consulting Engineers, CHTD Policy Number: PSW0001955 WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT ••CALIFORNIA We have the right to recover our payments from anyone liable for an Injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. ( 'his agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the Callfornia workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description All persons or organizations that are party to a contract that Jobs performed for an person or organization requires you to obtain this agreement, provided you that you have agreed with in a written contract executed the contract before the loss to provide this agreement REVIEWED BY: EUNICE HEREDIA (Pc of NICHCON-02 GRAI CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 5/17/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . _ PRODUCER License # OE67768 _RI - Erica Wilson _ IOA Insurance Services PHONE —� 4370 La Jolla Village Drive (AM,No,Ext: 858 754-0063 50233 vc,Nn: Sig) 574-6288 Suite 600 J6,. Erlca.Wilson@lolausa.com San Diego, CA 92122 IKIRLJRF3091 AFFORDING COVERAGE NAIL N INSURED Nichols Consulting Engineers, CHTD 1885 S. Arlington Ave., #111 Reno, NV 89509 F: Insurance THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ISR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS MILXM A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,DDD,DDD CLAIMS -MADE ❑ OCCUR X PSR0003222 5/17/2019 5/17/2020 TO RENTED 1,000,000 R ISES;(Faoccurrence]„ X Cont Liab/Sev of Int I MED EXP (Anr one oerean) 5 10,000 GEN'L AGGRE��'.� LIMIT APPLIES PER: PRO - I X I PRO- ❑ P}ZQOUCTS-COMP/OPAGt3 2,DDU,UOD POLICY I •' JECT LOC Deductible 0 OTHER. A COMBINED SINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITYfl $ X $ ANY AUTO X PSAGOO1184 5/17/2019 5/17/2020 BODILY INJURY, ar own BODILY INJURY(Paracclda t OWNED SCHEDULED AUTOS ONLY AUTOS P.ROP�EcIRdTe'lnIpAMAGE DD AUTOS AU7�TULY' rx ONLY Comp.: $500 Coll.: $500 X A UMBRELLA LIAB X OCCUR r EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS -MADE IP$E0003030 5/17/2019 5/17/2020 X &GGREGATE 5,000,000 DED X RETENTION$i f A WORKERS COMPENSATION X PER O7H- AND EMPLOYERS' LIABILITY Y / N pSWfl©01955 ANY PROPRIETOR/PARTNER/EXECUTIVE X 5/17/2019 5/17/2020 1 _E.Iw -E,&CH ACC [DENT 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L..I715Fr49E -EA E PLO EE 1,000,000 It s, descrliLm sander DESCRIPTION OF OPERATIONS below E1. DISEASE -POLICY LIMIT 1,000,000 B Prof LiablCims Made PKC108625 51i7120'9 511712020 Per Claim 2,000,000 B Ded.: $10k Per Claim PKC108625 5/17/2019 5/17/2020 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Agreement Nos. A-2017-172 and A-2017-290 City of Santa Ana, its officers, employees, agents and representatives are Additional Insureds with respect to General and Auto Liability per the attached endorsements as required by written contract. Insurance is Primary and Non -Contributory. Waiver of Subrogation applies to Workers' Compensation. 30 Days Notice of Cancellation with 1 Days Notice for Non -Payment of Premium in accordance with the policy provisions. REV WED BY: CERTIFICATE HOLDER CANCELLATION RIsIC Manhigem nt Ol 51Ori SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ` City of Santa Ana I AUTHORIZED REPRESENTATIVE M-36 PO Box 1988 ]Santa Ana. CA 927Q7 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Named Insured: Nichols Consulting Engineers, CHTD Policy Number: PSB0003222 RLI Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack° FOR DESIGN PROFESSIONALS BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM - SECTION II — LIABILITY C. WHO IS AN INSURED is amended to include as an additional insured any person or organization that you agree in a contract or agreement requiring insurance to include as an additional insured on this policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by you or those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "product -completed operations hazard". 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this policy. b. This insurance does not apply to the rendering of or failure to render any "professional services". c. This endorsement does not increase any of the limits of insurance stated in D. Liability And Medical Expenses Limits of Insurance. 3. The following is added to SECTION III H.2. Other Insurance — COMMON POLICY CONDITIONS (BUT APPLICABLE ONLY TO SECTION II — LIABILITY) However, if you specifically agree in a contract or agreement that the insurance provided to an additional insured under this policy must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs after you have entered into that contract or agreement; or b. The "personal and advertising injury" for which coverage is sought arises out of an offense committed after you have entered into that contract or agreement. 4. The following is added to SECTION III K. 2. Transfer of Rights of Recovery Against Others to Us — COMMON POLICY CONDITIONS (BUT APPLICABLE TO ONLY TO SECTION II — LIABILITY) We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal and advertising injury" arising out of 'your work" performed by you, or on your behalf, under a contract or agreement with that person or organization. We waive these rights only where you have agreed to do so as part of a contract or agreement with such person or organization entered into by you before the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. PPB 304 06 10 Page i or i Named Insured: Nichols Consulting Engineers, CHTD 1-his endorsement modifies insurance provid6id Under' the tollow.1no." BUSINESS AUMCOVERAGE-FORM A. 0roadFarm NAmedInsured 'The following is added to.. the SECTION.11 — LIABILITY Coverage,: Paragraph-A.I. Who Is -An Insured Provision: Anybusiness entity newly.acqUired or formed by you during the policy perie-d, provided. you. own fifty percent (50%) or more of the business entity and the business entity, is not separately insured: for Business. AiAo Coverage: Goverage is extended up to a: maximum :of one hundred eighty (.1.80:Y days following, the acquisition. or formation of the business entity. Thi.a provision;. does- not. apply to any person. or. .orQanization for which coverage is excluded by., en dmernent. B. Employees As Insureds The, following is: added to the SECTION 1.1 — LIABILITY O.QVE KA-GE, Fdragraph A.I. Who It A" Insured Provision: .Any "employee" of yours it an "insured" while using ;P, covered - "auto" you don't. own., hire Or Ocirrow in your bLpine.5s or your Personal W. gffa rs. C. E311prikitt'Addlitional lu.sur.64 `Th(following is added to thO. SECTION...11. — LIABILITY COVERAGE, Faragrqp.h -A. 1. Who: It. An Insured Rrovision: Any persiori or oF10ailization that you are, required to include as an additional insured on :this cover -age form in a contract or agreement that is executed by you b0fore the 1odily injury" or 'property damage" or,purs is an 'insured". for 100flity- coverage, but only for damages to which this insurance appliesand otity W the. exlienl. LhaL penaorj or uryo.rifzal.ioli qualifies. �s an 10_fired" under the,.Mn o 19 A Insured. provision- contained- in SECT[.ON 11 — LIAE11LITY COVERAGE. I tie insurance provided to,the. additional. Insured Nivill be on:a primaryand non-contributorybasis to the additi-onal inSLIf-ed'S ovuh business. .0 erage if you are. required to do so' in a contract t or zqreOmerif- that is executed by you before the "Oodi . Iy injury" Or "property damage" occurs. D. Blanket Waiv.er Of. Subrogation. The following is added to the' SECTION IV — BUSINESS: AUTO OONDITIONS, A. 1_656 Conditions, 15: Transfer Of Rights: Of Recovery ;Ag ainst 01t1ie.r.5 To. Us: 0PAS00 03 11 Policy Number: PSA0001 184 -WO Waive any rightof reooyery we may have against any'person.or organization to the extent required of 'you by 'a contract executed prior t6 any ",RCoj6Dntlor provided 'that the i'accidont". nF floss" :arises out of the operation* contemplated by such contract. The waiyer applies only to the person or drganization%de-signated in Such contract. E. Employee Hir-ed,Autos: I. The fallowing is. added to the :.SCOTION 11 � LIABILITY: COVERRAG IE- Paragraph A.I. Who Is An Insured Pirovision: Air "urriployee'.' oF yours- ilu,arl "ilismod" while operating an, "aultd! hired or rented under a contract or agreement in that "employee's" name, -with Y,01_11- Dermission, ;while performing duties related to*the conduct of your business. - 2, Changes In Gen e ial Conditions: !4,aragrapm S.b, of the: otner insurance Condibon in the BUSINESS AUTO CONDITIONS is deleted and replaced with the following; b, For Hired Auto Phy8iGal C$a1age. Coverage, the - following are -deemed to be covered "auto e'yqu:own: (1:j Any covered "auto!' you lease, hire.: Tent or'borrow; arid (2).Any, covered `<aUtd' hired or riorited by. your "employ..."" Linder a Qontrat,-Hn.that individual "employeds" name, with .your pe-rilli-ssion, while perrurmh-.Ig dubtm .related to the cotIdLict of yo(g.businpa& However, any, '�atitd' that is rased, hired, r0hted or borrowed with adrivet is not 8 covered: "auto Fe,11ovy. (Employee. Coveragq SECTION 11 — LIABILITY GOVEIA-AGE, Excluslo.n B.S, does. not apply if you ti&vo workers compensation insurance inJarce covering all of your G. Auto,. Loan Lease: Gap: Coverage SECTION III — PHYSICAL DAMAGE COVERAGE, C. Limit Of'Insur.Inc.0, is amended by the addition 6f'the foll6wing: In the.. event of a, total "loss" to 4 *bovered "auto" showh in the Schedule of Qeclarations we will pay anyunpaid artiount due on thelease or n for a oovei�ed "auto". less: �7 v71. I1(1 I Named Insured: Nichols Consulting Engineers, CHTD Policy Number: PSW0001956 WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description All persons or organizations that are party to a contract that Jobs performed for an person or organization requires you to obtain this agreement, provided you that you have agreed with in a written contract executed the contract before the loss to provide this agreement